| NPI | 1538456363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2017010592) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2017010592) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 42254) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2023-11-20 |